Oral Hygiene in Elderly: Influence of Instruction, Dentifrices and Brushes

Materials and methods: 100 nursing home residents in Cologne/Germany and an adjacent county (Rhein-Erft-Kreis) were devided into 5 groups. 4 groups got manual, 1 group got electrical dental brushes. 3 anonymousized dentifrices (A=Blend-a-med Complete (Procter&Gamble), B=Elmex sensitive (GABA), C=Odol med 3 (Glaxo Smith Kline)) were selected. One manually brushing group, the electrically brushing group and the non-instructed group (control group) got dentifrice A, the other two groups got B and C, respectively. This study was double-blinded and selective. Edentulous seniors were excluded. Assessment parameters (Papilla-Bleeding-Index and Quigley-Hein-Index) and the tooth color were evaluated by probing and coloring in the beginning, after 3 and 6 weeks. Statistics were done by SPSS 12.0 using Kruskal-Wallis and Wilcoxon-Test (significance p<0.05).

Results: Most seniors showed higher plaque scores on molars than on incisors. The periodontal indices did not change significantly over the examination period. Between 3 manually brushing groups no significant differences could be found. Moreover, all parameters of instructed seniors did not increase in contrast to control group. However, electrically brushing residents showed significantly lower values of both parameters compared to manually brushing participants. Tooth color did not change in any case.

Conclusion: Particularly, manual and visual impairment in elderly might influence individual oral hygiene. Because of manual impairments only electrical brushing seemed to have an hygiene-increasing effect, whereas professional instruction did not support oral hygiene significantly. Hence we conclude that especially the daily use of electrical dental brushes might increase oral hygiene in impaired nursing home residents.